title: Associations of serum fetuin-A levels with insulin resistance and vascular complications in patients with type 2 diabetes.
abstract: OBJECTIVE
  We examined the relationship between serum fetuin-A, insulin resistance (IR), metabolic syndrome (MS) and vascular complications including cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A total of 172 T2DM patients were recruited and evaluated for diabetic microangiopathies (nephropathy, retinopathy and peripheral neuropathy) including CAN. Serum fetuin-A levels were measured by enzyme-linked immunosorbent assay (ELISA), and the IR was assessed by the index of homeostasis model [homeostasis model assessment-insulin resistance (HOMA-IR)]. Atherosclerotic burden was assessed by ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV).
  
  
  RESULTS
  Serum fetuin-A levels showed significant positive correlations with HOMA-IR (r = 0.196, p = 0.022), and the mean levels of HOMA-IR were significantly increased progressively across fetuin-A tertiles (p for trend = 0.044). Serum fetuin-A showed significant positive correlations with baPWV, systolic blood pressure (BP), total cholesterol, triglycerides, serum fasting c-peptide and negative correlations with ABI. Serum fetuin-A levels were also negatively correlated with serum adiponectin and positively correlated with serum tumour necrosis factor-α (TNF-α). The mean levels of serum fetuin-A were not significantly different according to the presence of each microangiopathies including CAN. Also, the mean levels of serum fetuin-A were not different between patients with MS and without MS.
  
  
  CONCLUSIONS
  This present study showed that levels of serum fetuin-A are significantly associated with IR and arterial stiffness assessed by baPWV, while there are no associations with each microangiopathies in patients with T2DM.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea.
authors.forename: Chan-Hee
authors.initials: CH
authors.lastname: Jung
authors.forename: Bo-Yeon
authors.initials: BY
authors.lastname: Kim
authors.forename: Chul-Hee
authors.initials: CH
authors.lastname: Kim
authors.forename: Sung-Koo
authors.initials: SK
authors.lastname: Kang
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Jung
authors.forename: Ji-Oh
authors.initials: JO
authors.lastname: Mok
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000378:metabolism; D005215:Fasting / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D060749:alpha-2-HS-Glycoprotein / Q000096:biosynthesis*
chemical_list: D052242:Adiponectin; D060749:alpha-2-HS-Glycoprotein; D002784:Cholesterol
keywords: Fetuin-A; insulin resistance; metabolic syndrome; microangiopathies; type 2 diabetes mellitus